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Fungal Infections of Implantation: More Than Five Years of Cases of Subcutaneous Fungal Infections Seen at the UK Mycology Reference Laboratory. J Fungi (Basel) 2022; 8:jof8040343. [PMID: 35448574 PMCID: PMC9028115 DOI: 10.3390/jof8040343] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 01/20/2023] Open
Abstract
Subcutaneous fungal infections, which typically result from traumatic introduction (implantation) of fungal elements into the skin or underlying tissues, can present as a range of different clinical entities including phaeohyphomycosis, chromoblastomycosis, subcutaneous nodules or masses, and genuine eumycetoma. Here, we mined our laboratory information management system for such infections in humans and domestic animals for the period 2016–2022, including (i) fungal isolates referred for identification and/or susceptibility testing; (ii) infections diagnosed at our laboratory using panfungal PCR approaches on infected tissue; and (iii) organisms cultured in our laboratory from biopsies. In total, 106 cases were retrieved, involving 39 fungal species comprising 26 distinct genera. Subcutaneous infections with Alternaria species were the most frequent (36 cases), which possibly reflects the ubiquitous nature of this common plant pathogen. A substantial proportion of Alternaria spp. isolates exhibited reduced in vitro susceptibility to voriconazole. Notably, a significant number of subcutaneous infections were diagnosed in renal and other solid organ transplant recipients post transplantation, suggesting that humans may harbour “inert” subcutaneous fungal elements from historical minor injuries that present as clinical infections upon later immunosuppression. The current study underscores the diversity of fungi that can cause subcutaneous infections. While most organisms catalogued here were responsible for occasional infections, several genera (Alternaria, Exophiala, Phaeoacremonuim, Scedosporium) were more frequently recovered in our searches, suggesting that they possess virulence factors that facilitate subcutaneous infections and/or inhabit natural niches that make them more likely to be traumatically inoculated.
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Fungal keratitis caused by Pseudallescheria boydii: clinical and mycological characteristics. J Ophthalmic Inflamm Infect 2021; 11:30. [PMID: 34557976 PMCID: PMC8460684 DOI: 10.1186/s12348-021-00255-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 07/28/2021] [Indexed: 11/10/2022] Open
Abstract
Background Pseudallescheria keratitis is rare but important type of fungal keratitis because of the inherently resistance of the organism to many existing antifungal agents. Methods Slit-lamp and confocal microscopy were used for clinical examinations. Fungal isolates were identified based on morphological characteristics and DNA sequence of the internal transcribed spacer region (ITS). In vitro antifungal susceptibility testing for fungal isolates was performed according to the Clinical and Laboratory Standards Institute (CLSI, M38-A2). Result All patients had a history of ocular trauma. In clinical examination hypopion were seen in three patients. The main antifungal medications were topical voriconazole. After treatment the visual acuity of all patients improved in 2–3 weeks. Conclusion All four patients of Pseudallescheria keratitis had similar clinical features. Accurate and rapid identification of species should be helpful in treating p. boydii keratitis.
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Cerri L, Geroli L, Al Oum M, Basso P, Donati S, Vinciguerra R, Galli A, Cattaneo J, Congiu T, Nubile M, Gambi A, Gallenga PE, Azzolini C. [Battery of rockets "Scedosporium Apiospermum" in mycotic keratitis]. J Fr Ophtalmol 2014; 37:269-70. [PMID: 24576568 DOI: 10.1016/j.jfo.2013.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 11/04/2013] [Accepted: 11/22/2013] [Indexed: 11/28/2022]
Affiliation(s)
- L Cerri
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - L Geroli
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - M Al Oum
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - P Basso
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - S Donati
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - R Vinciguerra
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - A Galli
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - J Cattaneo
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - T Congiu
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie
| | - M Nubile
- Università degli Studi "G. D'Annunzio" di Chieti-Pescara, 66100 Chieti, Italie
| | - A Gambi
- Dipartimento di Salute Pubblica, ASL2 Abruzzo, 66100 Chieti, Italie
| | - P E Gallenga
- Università degli Studi "G. D'Annunzio" di Chieti-Pescara, 66100 Chieti, Italie
| | - C Azzolini
- Clinica Oculistica, Università degli Studi dell'Insubria, Ospedale di Circolo e Fondazione Macchi Varese, Viale Borri 57, 21100 Varese, Italie.
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Lee S, Lee DW, Lee HS, You IC. A Case of Fungal Keratitis Scedosporium apiospermum. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.4.675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Saem Lee
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
| | - Dong Wook Lee
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
| | - Hye Soo Lee
- Department of Labaratory Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - In Cheon You
- Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea
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